NURSING INFORMATICS

• The term informatics combined the terms “information” and “automation” to name automatic information processing.

• The combination of “informat” with the suffix “ics” broadened the definition to address the actual science and inherent theories of information and information processing.

• As information technology began to be applied within various disciplines and social arenas, the term “informatics” was linked to the specific field in question, for instance, medical informatics, health informatics, business informatics, and so on.

• In 1980, Scholes and Barber applied this new term to the art and science of nursing, coining the term, “nursing informatics”, which they defined as “...the application of computer technology to all fields of nursing-- nursing services, nurse education, and nursing research” (p 73).

Themes

• Antithesis refers to ideas presented in the literature that purport that the use of computers and other information technologies in health care is a threat.

• Artifact refers to the notion that technology of all kinds, including the contemporary inclusion of information technologies in nursing is an inherent, almost seamless cultural phenomenon, one that is long-standing and can be taken for granted as part of nursing evolution

• Utility literature presents information technologies as simple, benign, and useful tools that nurses control and apply to their practice, research, studying, and management activities.

• The concept of Technique focuses on the application of information technologies in nursing aimed to boost productivity and efficiency, promote best practices and evidenced-based practice, and concretely record nursing activities electronically.

• focus on Agency incorporates actor-network theory, technological agency in its' own right, and how nurses interact with ICTs in an interactive and intense, almost reciprocal way.

• The notion of Networks entails an examination of the application of information technologies in a collaborative way: in interactions with other people, such as colleagues, interdisciplinary team members, clients, and communities of practice and inquiry, sometimes on a global scale.

• Finally, the theme of Power emanates from a disciplinary perspective, including the consequences of prestige, influence, legitimacy, govern mentality, and social access.

• Together, these seven themes provide a rich, sometimes discordant yet crucial analysis of the varied philosophical and active ways that information technology and informatics are enacted and applied in the nursing arena.

Definition 1

• The use of technology and/or a computer system to collect, store, process, display, retrieve, and communicate timely data and information in and across health care facilities that administer nursing services and resources, manage the delivery of patient and nursing care, link research resources and findings to nursing practice, and apply educational resources to nursing education.

Second definition

• The use of information technologies in relation to those functions within the purview of nursing, and that are carried out by nurses when performing their duties.

• Therefore, any use of information technologies by nurses in relation to the care of their patients, the administration of health care facilities, or the educational preparation of individuals to practice the discipline is considered nursing informatics.

Third definition

• A combination of computer science, information science, and nursing science designed to assist in the management and processing of nursing data, information, and knowledge to support the practice of nursing and the delivery of nursing care

Fourth definition

• A specialty that integrates nursing science, computer science, and information science in identifying, collecting, processing, and managing data and information to support nursing practice, administration, education, and research and to expand nursing knowledge.

• The purpose of nursing informatics is to analyze information requirements; design, implement and evaluate information systems and data structures that support nursing; and identify and apply computer technologies for nursing.

• Beyond the definition, the goal of nursing informatics is to improve the health of populations, communities, families, and individuals by optimizing information management and communication.

• This includes the use of information and technology in the direct provision of care, in establishing effective administrative systems, in managing and delivering educational experiences, in supporting lifelong learning, and in supporting nursing research.

Essential informatics activities

• needs analysis requirements determination, • structured system analysis, design, selection,

implementation, and evaluation. • Reorganizing data presentation in a document

to increase its information content• developing taxonomies to increase data sharing

across sites• conducting research related to the nursing data.

• To employ informatics theories, concepts, methods, and tools to analyze information and information system requirements; design, select, implement, and evaluate information systems, data structures, and decision-support mechanisms that support patients, nurses, and their human–computer interactions within health care contexts; and to facilitate the creation of new nursing knowledge.

• since nursing informatics began, the role of patients in health care and in informatics has expanded greatly.

• It is common knowledge now that the Internet provides patients with an unparalleled amount of information about health, and the use of computers by patients in the home is more ordinary.

• Past definitions were constructed with patients as implicit rather than explicit players in health computing.

• Technology, and the data it provides, can help nursing improve care in three ways: – a) by counteracting human error, – b) by improving human behavior, – c) by putting nurses where they can be most effective.

• Technology does this in two ways: with software that translates data into information and with hardware that improves the way nurses collect that data.

• Technology can help cultivate caring by providing the data healthcare organizations need to understand how and why errors occur to prevent them from doing so”

• Harnessing the power of modern information and communication technologies (ICTs) to health care entails such innovative applications as electronic health records (EHRs), telemedicine, telehomecare, and Internet-based information for the health care professional and consumers alike.

• An electronic medical record (EMR) is usually a computerized legal medical record created in an organization that delivers care, such as a hospital and doctor's surgery.

• Electronic medical records are a part of a local stand-alone health information system that allows storage, retrieval and manipulation of records

Evidence based practice(EBP)

• One of the strongest and most far-reaching current trends in health care is the application of evidence - based practice through the development of research and information technology/informatics.

• This trend is visible across all sectors of nursing, including practice, education, research, and administration.

EBP……..ct

• The rationale behind this trend is to improve client care by selecting best practice options grounded in viable research, and to expand the theoretical foundations of all health professions.

• The ultimate goal is to shift health care decisions, choices, and actions to a “higher”, more scientific, research and theoretically-based level.

• A common conceptual basis for nursing and health informatics consists of a triad of data, information, and knowledge where nursing data gathered manually, or using computers and other technologies are combined and categorized into meaningful information, which when reflected on and logically analyzed, become nursing knowledge.

• “Data transformed into information and further transformed into knowledge assists healthcare staff in making knowledge-based decisions--choices based on the patient's total healthcare picture.

• Systemwide data provides a means to analyze overall process effectiveness and to spot areas needing change.

• This type of information management is instrumental in analyzing indicators that correlate nursing actions--such as the percentage of R.N. care hours versus all nursing care hours--with patient outcomes”

• The nurse administrator must help develop the IS strategic vision to ensure selection of the hardware and software needed for applications that can be used in many units or linked with other facilities.

• These key applications will provide fundamental systems support for nursing department operations, such as workforce, financial and quality management systems.

• Systems for patient classification (e.g., analyzing patient acuity level to determining level of care needed) are critical to support nursing administration functions.

• In financial management, linking patient classification data, staffing requirements, and evidence-based practice data to a budget methodology can help justify the nursing department's annual operating budget and expedite budget preparation”

• Nurses and technologies interact to form actor networks within the workplace arena.

• New technologies are also used to facilitate networks between nurses and other health care professionals.

• These networks manifest as virtual nursing and interdisciplinary work teams, interest groups, communities of practice, and other collaborative configurations.

• Networks within health care can manifest in several different configurations, including client focused networks such as in telenursing, e-health, and client support networks; work related networks including virtual work and virtual social networks; and learning and research networks as in communities of practice.

Challenges

• Criticisms of the technology usually center around three primary concerns:– a) Criticisms of the actual system such as

time consumption, inconvenient access, glitches, volume of data;

– b) Security issues i.e. health informatics law.– c) Nursing issues, such as the notion that

technology distracts nurses from providing quality individualized client care.

• Health informatics law deals with evolving and sometimes complex legal principles as they apply to information technology in health-related fields.

• It addresses the privacy, ethical and operational issues that invariably arise when electronic tools, information and media are used in health care delivery.

• Health Informatics Law also applies to all matters that involve information technology, health care and the interaction of information.

• It deals with the circumstances under which data and records are shared with other fields or areas that support and enhance patient care.

• Nurses are among many groups who still adhere to a humanist view of technology on the nonhuman and nonnatural side of the human/nonhuman, nature/artifice divide.

• The time has come for healthcare to leave the manual tools of the past in the past and turn to the enablers of the 21st century. The nursing profession is being transformed to meet the needs of the new world and will be a major player in the revolution”

• It is up to nurses as a group to choose whether they will be major players who simply perpetuate the modernistic workings of the system, or learn to apply technology to support the provision of true client-centered and supportive care.

• “Technology demands levels of attention, time and commitment that can be arduous for a nurse and inappropriate to the needs of patients and the clinical environment